Cardiovascular Diseases ; Humans ; Membrane Proteins ; Neoplasm Proteins ; Stromal Interaction Molecule 1

Adolescent ; Aged ; Aspergillosis ; microbiology ; pathology ; Aspergillus ; isolation & purification ; Brain Diseases ; drug therapy ; microbiology ; pathology ; surgery ; Diabetes Complications ; microbiology ; Diagnosis, Differential ; Female ; Humans ; Male ; Mucorales ; isolation & purification ; Mucormycosis ; drug therapy ; pathology ; surgery ; Nose Diseases ; drug therapy ; microbiology ; pathology ; surgery

Dissent and Disputes ; Humans ; Occupational Diseases ; diagnosis

Objective To investigate the role of electromyography(EMG) in diagnosis of nervous system diseases in children.(Met)-hods EMG tests were carried out in 354 patients with nervous system diseases,and the data and results of EMG tests were analyzed.Results One hundred and sixty-six patients′ results of EMG were abnormal.Among these abnormalities,36 cases were myogenic,47 cases were neurogenic,abnormalities of 69 cases were located in peripheral nerves,3 cases got positive in repetitive nerve stimulation(RNS),and 11 cases were on the borderline.In 36 myogenic patients,clinical diagnosis were as follow: progressive muscular dystrophy(PMD,18 cases),polymyositis(2 cases),mitochondrial encephalomyopathy(1 case), and the other 15 cases had no definite diagnosis.In 47 neurogenic patients,the diagnosis were spinal muscular atrophy(SMA,29 cases),sequela of poliomyelitis(2 cases),acute transverse myelitis(ATM,4 cases),and the other 12 patients had no definite diagnosis.In 69 cases of peripheral nerve abnormality,diagnosis were injury of brachial nerve(23 cases),hereditary motor sensory neuropathy(HMSN,2 cases),Guillain-Barre syndrome(GBS,9(ca)-ses),chronic inflammatory demyelinating polyradiculoneuropathy(CIDP,1 case),injury of facial nerve(4 cases),injury of common(pe)-roneal nerve(6 cases),metachromatic leukodystrophy(MLD,1 case),and the other 23 patients had no definite diagnosis.Three patients who got RNS positive were all diagnosed myasthenia gravis(MG),and ocular type(1 case),general type(2 cases).Eleven patients whose EMG results were borderline were all diagnosed indefinitely.One hundred and eighty-eight patients had normal results of EMG test.The diagnosis of these patients were included ocular MG(21 cases),cerebral palsy(CP,5 cases),ATM(2 cases),polymyositis((1 case)),and some other nervous system diseases(21 cases),and the other 138 were diagnosed indefinitely.Conclusions 1.EMG plays an important role in definite diagnosis of PMD,SMA,poliomyelitis and nerve injury;2.EMG can provide clue or basis in the differential(dia)gnosis of nervous system diseases which involved lower motor unit;3.EMG test has very low positive results in children with MG;(4.EMG) has little help in diagnosis of diseases involved upper motor unit only.

The clinical analgesic effect of electro-acupuncture (EA) stimulation (EAS) on breakthrough pain induced by remifentanil in patients undergoing radical thoracic esophagectomy, and the mechanisms were assessed. Sixty patients (ASAIII) scheduled for elective radical esophagectomy were randomized into three groups: group A (control) receiving a general anesthesia only; group B (sham) given EA needles at PC4 (Ximen) and PC6 (Neiguan) but no stimulation; and group C (EAS) electrically given EAS of the ipsilateral PC4 and PC6 throughout the surgery. The EAS consisting of a disperse-dense wave with a low frequency of 2 Hz and a high frequency of 20 Hz, was performed 30 min prior to induction of general anesthesia and continued through the surgery. At the emergence, sufentanil infusion was given for postoperative analgesia with loading dose of 7.5 μg, followed by a continuous infusion of 2.25 μg/h. The patient self-administration of sufentanil was 0.75 μg with a lockout of 15 min as needed. Additional breakthrough pain was treated with dezocine (5 mg) intravenously at the patient's request. Blood samples were collected before (T1), 2 h (T2), 24 h (T3), and 48 h (T4) after operation to measure the plasma β-EP, PGE2, and 5-HT. The operative time, the total dose of sufentanil and the dose of self-administration, and the rescue doses of dezocine were recorded. Visual Analogue Scale (VAS) scores at 2, 12, 24 and 48 h postoperatively and the incidence of apnea and severe hypotension were recorded. The results showed that the gender, age, weight, operative time and remifentanil consumption were comparable among 3 groups. Patients in EAS group had the lowest VAS scores postoperatively among the three groups (P<0.05). The total dose of sufentanil was 115±6.0 μg in EAS group, significantly lower than that in control (134.3±5.9 μg) and sham (133.5±7.0 μg) groups. Similarly, the rescue dose of dezocine was the least in EAS group (P<0.05) among the three groups. Plasma β-EP levels in EAS group at T3 (176.90±45.73) and T4 (162.96±35.00 pg/mL) were significantly higher than those in control (132.33±36.75 and 128.79±41.24 pg/mL) and sham (136.56±45.80 and 129.85±36.14 pg/mL) groups, P<0.05 for all. EAS could decrease the release of PGE2. Plasma PGE2 levels in EAS group at T2 and T3 (41±5 and 40±5 pg/mL respectively) were significantly lower than those in control (64±5 and 62±7 pg/mL) and sham (66±6 and 62±6 pg/mL) groups. Plasma 5-HT levels in EAS group at T2 (133.66±40.85) and T3 (154.66±52.49 ng/mL) were significantly lower than those in control (168.33±56.94 and 225.28±82.03) and sham (164.54±47.53 and 217.74±76.45 ng/mL) groups. For intra-group comparison, plasma 5-HT and PGE2 levels in control and sham groups at T2 and T3, and β-EP in EAS group at T3 and T4 were significantly higher than those at T1 (P<0.05); PGE2 and 5-HT levels in EAS group showed no significant difference among the different time points (P>0.05). No apnea or severe hypotension was observed in any group. It was concluded that intraoperative ipsilateral EAS at PC4 and PC6 provides effective postoperative analgesia for patients undergoing radical esophagectomy with remifentanil anesthesia and significantly decrease requirement for parental narcotics. The underlying mechanism may be related to stimulation of the release of endogenous β-EP and inhibition of inflammatory mediators (5-HT and PGE2).

Problem-based learning(PBL)is an important part of creative education in medical colleges.Choice and design of cases are of the vital importance to success or failure of PBL course.To enhance students' ability of independent,creative thinking,and their ability of analyzing and solving problems,the roles of primitive cases and model cases as well as interrelation between them were discussed respective- ly.Moreover,five basic principles to be followed in model case design for PBL in Medical Microbiology and Human Parasitology,i.e.objec- tivity,flexibility,consistency,illumination and relevance,were proposed in this study.

A series of adefovir mono-L-amino acid esters, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs with more potent anti-HBV activity and lower nephrotoxicity were designed and synthesized. Adefovir bis (L-amino acid) ester was used as lead compound, according to pathological and pharmacological findings that non-steroidal anti-inflammatory drugs can effectively inhibit the organic anion transporter 1 (hOAT1)-mediated adefovir phosphonic acid pairs of anion transport across tubular basement membrane thereby reducing the nephrotoxicity of adefovir. Flatten design principle was used to introducing non-steroidal anti-inflammatory drugs structural fragments to design and synthesize target adefovir mixture ester prodrugs. HepG2 2.2.15 cell line was used as in vitro anti-HBV activity evaluation model. Five compounds exhibited antiviral activity, and compound 18 showed the most potent anti-HBV activity and relatively high selective index (EC50 3.92 micromol L(-1), SI 9.97). HK-2 cell line was used as in vitro model to evaluate nephrotoxicity. Results suggested the target compounds have lower cytotoxicity than the positive control. Moreover, by analyzing the primary structure and activity relationship of these compounds, it could suggest that mono-L-amino acid ester, mono non-steroidal anti-inflammatory drugs carboxylic ester prodrugs strategy has significant potential in the acyclic nucleoside phosphonates prodrug design.

Adult ; Angiomyolipoma ; metabolism ; pathology ; surgery ; Carcinoma, Renal Cell ; metabolism ; pathology ; Diagnosis, Differential ; Humans ; Kidney Neoplasms ; metabolism ; pathology ; surgery ; MART-1 Antigen ; metabolism ; Male ; Melanoma-Specific Antigens ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Objective To assess the effectiveness of absorbable screws and metallic devices for treating tibial plateau fractures.Methods Fifty-seven cases of tibial plateau fractures were treated with internal fixation using absorbable screws(Group A),cannulated screws(Group B)and condylar buttress plates(Group C)in our hospital.According to Schatzker classification,there were 15 cases with typeⅠfractures,21 with typeⅡ,nine with typeⅢand 12 with typeⅣ,who were followed up for 6-51 months. Statistical analysis was performed to compare bone union and functional restoration of the knee between three groups.Results Bone union was achieved in all cases.Based on Merchant scale for knee func- tion,excellence rate was 84%(16/19)for Group A,92%(11/12)for Group B and 85%(22/26) for Group C,with no significant statistical difference.Conclusion Absorbable screws is as effective as metallic devices for treating tibial plateau fractures and has advantages of minimal invasion,few complica- tions and avoiding secondary operation.